O presente estudo objetivou traduzir, adaptar e validar a Escala de Atitudes frente ao álcool, ao alcoolismo e ao alcoolista EAFA para língua espanhola. Método. Estudo metodológico, que seguiu as diretrizes internacionais para tradução e adaptação de escalas de mensuração. A escala original foi adaptada para o idioma espanhol na cultura colombiana. A validade de construto da versão traduzida e adaptada foi realizada por meio da teoria clássica do teste representada pela análise fatorial confirmatória. A confiabilidade da versão em Espanhol da EAFAA foi testada pelo coeficiente de Alfa de Cronbach e Ômega de Mc Donald. Resultado. A validação de conteúdo, indicou índices de validade satisfatórios com IVC (0,97), PABAK ,(0,80), ICC (0,92). A análise fatorial confirmatória indicou bom ajuste do modelo da EAFA versão Espanhol, composta por 48 itens, divididos em quatro fatores. A análise da confiabilidade da escala estimada pelo Alfa de Cronbach apresentou índice satisfatório ( =0,80) resultado semelhante ao observado quando se testou a confiabilidade pelo teste de Mc Donald (= 0.90). Conclusões. A EAFA adaptada e traduzida para o idioma Espanhol, apresentou validade de conteúdo e qualidades psicométricas robustas, o que permite afirmar que se trata de um instrumento válido e confiável, capaz de medir as atitudes frente ao álcool, ao alcoolismo e a pessoa com transtornos relacionados ao uso de álcool com acerácea no contexto cultural Colombiano / The aim of this study was to translate, adapt and validate the instrument attitudes scale towards alcohol, alcoholism and alcoholic (EAFA) to Spanish language. Methodology: this methodological study followed the international guidelines on translation and adaptation of measurement scales, to adapt the original scale to the Spanish language in the Colombian culture. The construct validity of translate and adapted version was performed by the classical theory of the test represented by confirmatory factor analysis. The reliability of the Spanish version of EAFAA was tested by Cronbach alpha coefficient and omega of McDonald. Result: The instrument has indicated satisfactory validity rates with a CVI (0.97), Kappa Index (0.80) and ICC (0.92). The confirmatory factor analysis indicated proper adjustment of the model EAFA Spanish version, consisting of 48 items, divided into four factors. The scale reliability analysis estimated by alpha Cronbach presented satisfactory index ( = 0.80) similar to the result observed when tested by the McDonald test ( = 0.90). Conclusions: The EAFA adapted and translated into Spanish language, presented content validity and robust psychometric properties, which allows affirm that this is a valid and reliable instrument, able to measure the attitudes towards alcohol, alcoholism and persons with related disorders to alcohol use with accuracy in the Colombian cultural context

Terminally ill patients and their families describe hospital care as nonsupportive to their needs during the final phase of life. Nurses generally are not comfortable with a supportive role when caring for the dying and tend to adhere to a curative role. The purpose of this descriptive, correlational study therefore was to describe the attitudes of general staff nurses working on medical-surgical units in hospitals towards the care of the dying and to ascertain the relationship between these attitudes and the education and experience of the nurses. An adaptation of the model for role episode, conflict, and ambiguity by Kahn, Wolfe, Quinn, Snoek and Rosenthal (1964) was the applied theoretical framework. The sample consisted of 197 randomly selected registered nurses employed full or part-time on general adult medical-surgical hospital units in British Columbia. The majority of the sample were married, Protestant females, between the ages of 26 and 45 years who were prepared at the diploma level in nursing. The mean length of time worked as a nurse was 8.5 years with a mean of 7.5 years on medical-surgical units. Attitudes towards the care of the dying were generally ambiguous, neither negative nor positive as measured by scores obtained on the ‘Questionnaire for Understanding the Dying Person and His Family’. Additionally, half the respondents did not believe that nurses should be the primary health care professionals equipped to deal with the emotional reactions of the dying yet three-quarters of the sample believed that patients turned to nurses to discuss such emotional issues. Data revealed that close to two-thirds of the respondents had received structured death and dying content in their basic nursing education yet less than half furthered their death and dying education since graduation. Overall death education for the sample was low. A small positive correlation (r=-0.26) was found between respondents' death education and their attitudes towards the care of the dying; no significant association was found between respondents' level of general nursing education and their attitudes. Although there was variability in the amount of professional and personal death experience, over half of the respondents experienced between one and three terminally ill patient deaths on their medical-surgical units per month. Additionally, the majority of respondents had experienced the death of an immediate family member. Overall death experience was low to moderate. A small, but significant positive correlation (r=0.24) was found between overall death experience and attitudes' towards the care of the dying; no significant association was found between general experience and attitude. Findings suggest that supportive nursing care is not being demonstrated with dying patients and their families. However, the influencing natures of death education and death experience on nurses' attitudes are positive, thereby providing the nursing profession with two possible ways of positively influencing nurses' attitudes to the care of the dying. / Applied Science, Faculty of / Nursing, School of / Graduate

A replication of Reilly's study (1980) was conducted in order to describe the attitudes of community health nurses who work with parents and children toward child abusers; to determine the relationship between the attitudes of the community health nurses and selected social and professional variables; to compare the attitudes of these nurses to the attitudes of the registered nurses studied by Reilly (1980); to compare the attitudes of the community health nurses in the randomly selected group with the attitudes of the community health nurses in the convenience group; and last, to describe the data presented by the community health nurses in regard to their experiences with child abuse. The population consisted of community health nurses. One sample population of one hundred and fifty-seven subjects was randomly selected from the community health nurses employed by the British Columbia Ministry of Health. A second sample population of fifteen subjects was self-selected from the community health nurses employed in two of the Health Units of Metropolitan Health Services of Greater Vancouver. The attitudes of the community health nurses toward child abusers were measured by a Likert-type Attitudinal Instrument developed by Reilly (1980). Information regarding the selected social and professional variables was obtained by a biographical data sheet also developed by Reilly (1980). Data regarding the community health nurses' experiences with child abuse were collected by open-ended questions. The correlated data from the attitude scores and the background data sheet were analyzed through the process of inferential analysis and descriptive statistics. Data regarding the subjects' experiences with child abuse were summarized by the process of content analysis and descriptive statistics. The results of the study revealed that the community health nurses' attitudes toward child abusers were more favorable than unfavorable. This finding substantiated Reilly's (1980) finding regarding registered nurses' attitudes toward child abusers. In addition, it was shown that the variable, whether the subjects have seen an abused child, significantly affected the attitude scores of the community health nurses in the randomly selected group. The study did not support Reilly's (1980) findings that the subjects' present level of education and whether the subjects have met an abusing parent or detected a case of child abuse significantly affected the attitude scores. The study also found that community health nurses experience a multitude of frustrations in the management of child abuse. In addition, it was found that a significant percentage of the nurses expressed a need for further instruction regarding the treatment of child abuse. / Applied Science, Faculty of / Nursing, School of / Graduate

Patient safety culture (PSC) is a critical factor in creating high reliability healthcare organizations. However, few studies to date have correlated PSC measures with actual safety outcomes. In particular, nursing home studies have only recently appeared in the literature. Nursing homes differ from hospitals in that the vast majority of direct care is provided by certified nursing assistants (CNAs), not licensed nurses. Thus nursing home PSC could differ in important ways from PSC in acute care institutions. This dissertation was a secondary data analysis that examined whether CNAs’ perceptions of patient safety culture were correlated with clinical outcomes in a random sample of 74 nursing homes in five randomly selected states. This study matched CNA PSC survey data using the Hospital Survey of Patient Safety Culture (HSOPSC) with Minimum Data Set (MDS), Area Resource File (ARF) and Online Survey Certification and Reporting (OSCAR) data from those same homes during the first two quarters of 2005. In the original study, 1579 nurse aides out of 2872 completed the survey, for a 55% response rate. In addition to clinical outcomes, this study examined the relationship between CNA PSC scores and staff turnover. The relationship between certain demographic variables, such as level of education, tenure as a CNA, and PSC scores was evaluated. The relationship between certain facility characteristics, such as profit status and bed occupancy was also assessed. An exploratory factor analysis of the original HSOPSC instrument was re-run for this nursing home CNA sample. Data were analyzed using Poisson regression and multilevel techniques; descriptive statistics were compiled for demographic data. Major findings from the regression analyses and combined GEE models suggest that certain factors, such as CNA turnover and LPN staffing may predict CNA PSC scores. CNA PSC scores were associated with rates of falls and restraint use, but were not associated with differences in pressure ulcer rates in this sample. Few associations for CNA PSC with individual subscales were identified. The exploratory factor analysis revealed some potential differences in how items and subscales factored in this nursing home CNA population. This dissertation represents an important step in the evaluation of CNA PSC in nursing homes and the relationship of PSC to safety outcomes. Future work on nursing home PSC and clinical and workforce outcomes is described.

How contract learning may be used in the introduction to clinical medicine is described, with the goal to develop and enhance self‐directed learning skills and attitudes of first‐ and second‐year medical students. Essential tasks associated with successful self‐directed learning are cited, and the contract method is described as a means for providing medical students with the opportunity to practise these tasks in the study of gerontology. The procedures followed in the implementation of the contract learning method are described, and its impacts on both need and motivation to continue learning about ageing and skills in directing independent learning projects are analysed and discussed. In addition, the implications of early preparation for doctor's lifelong learning are discussed.

京都大学 / 0048 / 新制・論文博士 / 博士(社会健康医学) / 乙第13004号 / 論社医博第8号 / 新制||社医||9(附属図書館) / 32932 / 京都大学大学院医学研究科社会健康医学系専攻 / (主査)教授 中山 健夫, 教授 木原 正博, 教授 黒田 知宏 / 学位規則第4条第2項該当 / Doctor of Public Health / Kyoto University / DFAM

Yes / Fidelity to the treatment protocol is key to successful trials but often problematic. This article reports the staff's views on delivering a complex rehabilitation intervention: patient-led therapy during inpatient stroke care. An exploratory qualitative study using focus groups with staff involved in a multicenter (n = 12) feasibility trial of patient-led therapy (the MAESTRO trial) was undertaken as part of the evaluation process. Purposive sampling ensured that participants represented all recruiting sites, relevant professions and levels of seniority. Data analysis used a Framework Approach. Five focus groups were held involving 30 participants. Five main themes emerged: the effect of the interventions, practical problems, patient-related factors, professional dilemmas, and skills. Staff felt the main effect of the therapies was on patients' autonomy and occupation; the main practical problems were the patients' difficulties in achieving the correct position and a lack of space. Staff clearly identified characteristics that made patient-led therapy unsuitable for some patients. Most staff experienced dilemmas over how to prioritize the trial interventions compared to their usual therapy and other clinical demands. Staff also lacked confidence about how to deliver the interventions, particularly when adapting the interventions to individual needs. For each barrier to implementation, possible solutions were identified. Of these, involving other people and establishing a routine were the most common. Delivering rehabilitation interventions within a trial is complex. Staff require time and support to develop the skills, strategies and confidence to identify suitable patients, deliver new treatments, adapt the new treatments to individuals' needs and balance the demands of delivering the trial intervention according to the treatment protocol with other clinical and professional priorities. TRIAL REGISTRATION: ISRCTN: ISRCTN29533052 . October 2011.

Bakgrund: Partnerrelaterat våld är ett folkhälsoproblem och kvinnor är de som är mest utsatta. Kvinnor utsatta för partnerrelaterat våld besöker sjukvården dubbelt så ofta jämfört med andra kvinnor. Sjukvårdspersonalen misslyckas ofta med att uppmärksamma och hjälpa kvinnorna. Syfte: Litteraturstudiens syfte är att belysa erfarenheter av mötet med sjukvårdspersonal för kvinnor utsatta för partnerrelaterat våld. Metod: Litteraturstudie av kvalitativ ansats. Tolv vetenskapliga kvalitativa studier har analyserats med hjälp av innehållsanalys. Tre kategorier och åtta underkategorier sammanställdes i resultatet. Resultat: Kvinnorna ville bli tillfrågade om partnerrelaterat våld av sjukvårdpersonalen. En del ansåg att det var svårt att avslöja våldet. Flera kvinnor uppgav att de inte fått den hjälp eller information de behövt. Kvinnorna som hade positiva erfarenheter belyste vikten av god information och ett empatiskt bemötande. Konklusion: Kvinnorna hade främst negativa erfarenheter av möten med sjukvårdspersonal. Sjukvårdspersonalen behöver få mer utbildning för att kunna ge en god vård. / Background: Intimate partner violence is a public health problem and women are more exposed. Women suffering from intimate partner violence are visiting the health care twice as much compared to other women. The health care workers often fails to identify and help the women. Aim: The aim of the study is to illuminate the experience of encounters with health care professionals for women exposed to intimate partner violence. Methods: Literature study with qualitative approach. Twelve scientific qualitative studies have been analyzed with content analysis. Three categories with eight subcategories were compiled into a result. Findings: The women wanted to be asked about intimate partner violence by health care professional. Many women found it difficult disclosing violence. Many women stated that they had not got the help or the information they needed.  Women who had positive experiences described the importance of relevant information and an emphatic approach. Conclusion: The women had mostly negative experiences of the encounters with the health care professionals. The health care professionals needs more education to be able to give a good health care.

Diss. (sammanfattning) Umeå : Univ., 2008. / Härtill 5 uppsatser.

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 4 uppsatser.